Anatomic and refractional correlations in earliest glaucomatous visual field defects / Correlações anatômicas e refracionais nos defeitos de campo visual em glaucoma inicial

ABSTRACT Purpose: In glaucoma, initial visual field scotomas can be peripheral or central, whereas central scotomas are more severe and can disrupt daily activities. Individual anatomical features may influence the distribution of retinal nerve fibers and the starting site of visual field defects in glaucoma. In this study, we aimed to correlate myopia and hyperopia or anatomical variation of the disk-fovea angle with initial central or peripheral lesions in the visual field. Methods: This cross-sectional study included patients with primary open-angle glaucoma divided into a group of isolated central or peripheral scotomas in the visual field with MD > or equal to -6 dB, correlating with the degree of ametropia and anatomical variations, such as the disk-fovea angle. Results: We included 52 patients with glaucoma. Of 20 myopic patients, 6 (30%) had central scotomas, and 14 (70%) had peripheral scotomas. Of 32 hyperopic patients, 12 (37.5%) had central scotomas, and 20 (63.5%) had peripheral scotomas. Regarding the disk-fovea angle, 25 eyes had the disk-fovea angle of < -7°, with 9 (36%) eyes presenting with central scotoma, and 27 eyes presented with the disk-fovea angle of > -7°, with 9 (33.3%) eyes presenting with a central scotoma. Conclusion: This study showed an association between ametropia and scotomas on the perimetry in patients with glaucoma. Patients had a higher incidence of peripheral scotomas, but hyperopic patients had a greater number of central scotomas than myopic patients, and myopic patients had more peripheral scotomas than hyperopic patients. The disk-fovea angle was not correlated with scotomas in initial glaucoma.

RESUMO Objetivos: No glaucoma, os escotomas iniciais no campo visual podem ser periféricos ou centrais. Os escotomas centrais são mais graves e podem atrapalhar as atividades diárias. As características anatômicas individuais podem influenciar a distribuição das fibras nervosas da retina e o local inicial dos defeitos do campo visual no glaucoma. Nesse estudo buscamos correlacionar a miopia e a hipermetropia ou a variação anatômica do ângulo disco-fóvea com lesões iniciais centrais ou periféricos no campo visual. Métodos: Este foi um estudo transversal incluindo pacientes com glaucoma primário de ângulo aberto divididos em grupo de escotomas isolados central ou periférico no campo visual com MD > ou igual a -6 dB, correlacionando com o grau de ametropia e variações anatômicas como o ângulo disco fóvea. Resultados: Incluímos 52 pacientes com glaucoma. Dos 20 míopes, 6 (30%) apresentaram escotoma central e 14 (70%) escotoma periférico) e 32 olhos hipermetrópicos com 12 (37,5%) escotomas centrais e 20 (63,5%) escotomas periféricos. Sobre o ângulo disco fóvea, 25 olhos tiveram ângulo disco fóvea menor que -7º com 9 (36%) olhos apresentando escotoma central e 27 olhos com ângulo disco fóvea maior que -7º com 9 (33,3%) olhos apresentando escotoma central. Conclusão: Este estudo mostrou associação da ametropia e os escotomas na perimetria em pacientes com glaucoma. Pacientes apresentaram maior incidência de escotomas periféricos, porém hipermétropes apresentaram maior quantidade de escotoma central que os míopes e os míopes mais escotomas periféricos que os hipermetropes. O ângulo disco fóvea não foi correlacionado com escotomas na perimetria no glaucoma inicial.

Aberraciones corneales de bajo orden en pacientes con ametropías miópicas

Objetivo: Caracterizar las aberraciones corneales de bajo orden en pacientes con ametropías miópicas. Métodos: Se realizó un estudio descriptivo, observacional y transversal, con una muestra de 104 ojos de 104 pacientes adultos con ametropías miópicas y un grupo control de 104 ojos de 104 voluntarios emétropes, que asistieron a consulta de Cirugía Refractiva del Instituto Cubano de Oftalmología. Se definieron las variables demográficas, clínicas y para la cuantificación de las aberraciones corneales la elevación-depresión y el valor cuadrático medio, aportadas mediante el mapa aberrométrico del Pentacam HR. Resultados: Hubo un predominio del sexo femenino, el rango de edad estuvo comprendido entre 18 y 39 años en ambos grupos. La mediana del equivalente esférico de los pacientes de ametropías miópicas fue -3,25 dioptrías, con agudeza visual sin corrección de 0,10, esfera de -2,63 D y cilindro de -1,00 D, 91 ojos (87,50 %) tenían astigmatismo miópico compuesto. Los valores de elevación-depresión y el valor cuadrático medio de bajo orden fueron mayores en los pacientes con ametropías miópicas que los emétropes (p< 0,001). El astigmatismo vertical, desenfoque y el astigmatismo horizontal no presentaron diferencia estadísticamente significativa entre ambos grupos. Conclusiones: La miopía con o sin astigmatismo se debe estudiar y tratar como una aberración de bajo orden. Los valores de elevación-depresión y cuadrático medio son superiores en los ojos con ametropías miópicas respecto a los emétropes.

Objective: To characterize low-order corneal aberrations in patients with myopic ametropia. Methods: A descriptive, observational and cross-sectional study was carried out with a sample of 104 eyes of 104 adult patients with myopic ametropia and a control group of 104 eyes of 104 emmetropic volunteers, who attended the Refractive Surgery Clinic of the Cuban Institute of Ophthalmology. Demographic and clinical variables were defined, and for the quantification of corneal aberrations, elevation-depression and average square value, provided by means of the Pentacam HR aberrometric map. Results: There was a predominance of female sex, the age range was between 18 and 39 years in both groups. The median spherical equivalent of myopic ametropia patients was -3.25 diopters, with uncorrected visual acuity of 0.10, sphere of -2.63 D and cylinder of -1.00 D, 91 eyes (87.50%) had compound myopic astigmatism. Elevation-depression values and low-order root average square value were higher in patients with myopic ametropes than emmetropes (p< 0.001). Vertical astigmatism, defocus and horizontal astigmatism showed no statistically significant difference between the two groups. Conclusions: Myopia with or without astigmatism should be studied and treated as a low-order aberration. The elevation-depression and average square values are higher in eyes with myopic ametropia than in emmetropic eyes.

Multimedia visual physiological stimulation combined with stereoscopic system training for the treatment of ametropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the efficacy of multimedia visual physiological stimulation combined with stereoscopic system training in the treatment of ametropic amblyopia in children.METHODS: A total of 102 patients(102 eyes)with ametropic amblyopia admitted to our hospital from June 2021 to June 2022 were randomly divided into two groups. The control group consisted of 51 patients(51 eyes)who received multimedia visual physiological stimulation on the basis of conventional treatment, while the observation group consisted of 51 patients(51 eyes)who received stereoscopic training on the basis of the control group. The binocular fusion function, binocular stereopsis and binocular disparity of the two groups of children were evaluated at 3mo after treatment, and the clinical efficacy was assessed based on the improvement of vision.RESULTS: After 3mo of treatment, the normal rates of binocular fusion function, binocular stereopsis, and binocular disparity in the observation group were significantly higher than those in the control group(all P&#x003C;0.05). The total effective rate of the observation group was significantly higher than that of the control group(94.1% vs. 60.8%, P&#x003C;0.05), and the total effective rate of treatment in children of different ages in the observation group was higher than that in the control group(P&#x003C;0.05), with children aged 6-8 having the highest effective rate of treatment; The total effective rate of treatment for children with mild to moderate amblyopia in the observation group was higher than that in the control group(94.0% vs. 61.2%, P&#x003C;0.05).CONCLUSION: The combination of multimedia visual physiological stimulation and stereoscopic system training has a good therapeutic effect on ametropic amblyopia, which can promote visual recovery, help reconstruct binocular stereopsis, and has a better effect on children aged 6-8 years or children with mild to moderate amblyopia.

Evaluation of Visual Acuity of Ametropia with Visual Event-Related Potential Nogo-P3 Component / 法医学杂志

OBJECTIVES@#To analyze the Nogo-P3 component of event-related potential (ERP) in the process of visual acuity processing, to provide electrophysiological evidence for objective evaluation of visual acuity.@*METHODS@#Twenty-six subjects with no other ocular diseases except for ametropia were recruited, and all subjects had uncorrected visual acuity both eyes 1/10 (evaluated using Monoyer chart). Block letter E with different visual angles and directions were used as graphic stimuli. The Go/Nogo paradigm was used for ERP studies. The visual angle of Go stimulation angle was 1°15', Nogo stimuli were 1°15', 55', 24' and 15'. The visual acuity test was performed on each of the two naked eyes separately in all subjects, and the characteristics of the Nogo-P3 component were analyzed.@*RESULTS@#The latency of Nogo-P3 showed no difference between the stimuli of 1°15' and 55', and between Nogo stimulation angle 24' and 15'. There was significant difference between Nogo stimulation angle 1°15' and 24', and between Nogo stimulation angle 1°15' and 15' (P<0.05). There was significant difference between Nogo stimulation angle 55' and 24', and between Nogo stimulation angle 55' and 15' (P<0.05). No significant differences were observed in the Nogo-P3 amplitude among Nogo stimulation.@*CONCLUSIONS@#In the Go/Nogo paradigm, Nogo-P3 can reflect the cognitive response of subjects to Nogo stimulation, which can be used for objective evaluation of visual acuity.

Fréquence des amétropies aux cliniques universitaires du graben en République Démocratique du Congo

Introduction : Les amétropies sont des troubles de la vision dus à un fonctionnement défectueux du système optique formé par la succession la cornée, le cristallin et la rétine. Les vices de réfraction (myopie, hypermétropie, astigmatisme, presbytie) donnent des images floues sur la rétine. L'Organisation Mondiale de la Santé (OMS) estime à 153 millions le nombre des personnes souffrant de la déficience visuelle due à des vices de réfraction non corrigés. Le présent travail a pour objectif de déterminer la fréquence et le profil des patients avec amétropies aux Cliniques universitaires de Graben. Méthodes : Notre étude était du type descriptif transversale ayant couvert une période allant du 01 Janvier au 31 Décembre 2020. Notre échantillon a été exhaustif, c'est-à-dire il a été constitué de toute la population d'étude. Résultats : La fréquence des amétropies a été de 11,47%. L'astigmatisme était l'amétropie la plus représentée avec 47,86 %suivi de la myopie avec 38,90% et de l'hypermétropie avec 13,24%. La tranche d'âge la plus touchée est celle des adultes, âge (21-60 ans) avec 73,9% et la moins touchée est de 0-10 ans avec 0,8%. Le taux des déficiences visuelles a diminué après la correction optique et les cas de bonne vision sont passés de 81,1% à 99,4% de bonne acuité visuelle. Conclusion. Les amétropies constituent un réel problème de santé publique. De ce fait, nous encourageons le check up volontaire, comme les amétropies sont souvent méconnues et indolores, pourtant une cause non négligeable de déficience visuelle facilement évitable.

Introduction: : Ametropia are vision disorders due to damage to the visual system caused by a various abnormality in the cornea, lens and retina. The refractive errors (myopia, hyperopia, astigmatism, presbyopia) cause a very weak capacity for the eye retina to properly watch images. The World Health Organization (WHO) estimates that 153 million of people could be suffering from visual issues due to untreated refractive deficiencies. This study aimed to determine the frequency et profil of patients with ametropia. Methods: Our study was of a kind of crosssectional descriptive which covered a time interval from January 01 to December 31, 2020. Our sample was comprehensive and was based on several cases. Results: The frequency of ametropia was 11.47%. Astigmatism was the most prevalent ametropia with 47.86% followed by myopia with 38.90% and hyperopia with 13.24%.The most affected people are adults aged from 21 and 60 years with 73.9% and the least affected are children aged from 0 to 10 years with 0.8%.However, the rate of eyes abnormalities started decreasing after optical treatment and consequently the cases of eyes issues recoveries was about from 81.1% to 99.4% of sight improvement acuity. Conclusion: Ametropia is a real public health problem. As a result, we encourage voluntary check-ups, as ametropia is often unrecognized and painless, yet a significant cause of easily avoidable visual impairment.

Analysis on visual screening result of children aged 0-6 years old by using the SureSight automatic screening refractor in Binhu District, Wuxi City / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To provide a scientific basis for the development of children's eye health measures in Binhu District of Wuxi City by understanding the visual development status of children aged 0-6 years old in the region.<p>METHODS: A total of 3 695 children of 0-6 years old from preschool children in Binhu District received quickly check of eye's refractive status by using the SureSight automatic screening refractor, and determine the results by referring to the refractive screening referral standard norm for each age groups offered by the US Welch Allyn company. All participating preschool children have completed a vision screening and a comprehensive eye examination. <p>RESULTS: The total of abnormal rate was 9.76%, suspicious rate was 5.40% in vision screened children, along with the age increase, the abnormal and suspicious detection rates had a tendency to rise, differences in vision screening results of each age group were statistically significant(χ²=15.913, <i>P</i>=0.014), and differences between boys and girls had no statistical significance(χ²=7.200, <i>P</i>=0.066). The highest proportion of abnormal vision was astigmatism(13.89%, 17.96%, 17.62%, 11.50%), followed by hyperopia(0.35%, 1.91%, 3.60%, 8.86%)and anisometropia(0.69%, 0.67%, 1.64%, 2.07%)in different age groups. Hyperopia(4.38%), myopia(0.82%), astigmatism(15.65%), anisometropia(1.42%)and any refractive(0.466%), these five types in the distribution of various age groups. The prevalence of astigmatism in preschool children in 0-3 years old were 6.94%(95%<i>CI</i>: 4.90%-9.00%)and the 3-4 years old were 8.98%(95%<i>CI</i>: 7.80%-10.20%), the 4-5 years old were 8.81%(95%<i>CI</i>: 7.70%-9.90%), the 5-6 years old were 5.75%(95%<i>CI</i>: 4.80%-6.70%). The prevalence of astigmatism in different age groups had no statistical difference(χ²=0.872, <i>P</i>=0.929).<p>CONCLUSION: Astigmatism was the most common type of ametropia in preschool children, followed by hyperopia and anisometropia. Although no myopia was found, it confirmed the previous research that myopia was not formed at early age. Preschool children vision screening and eye care should be implemented regularly.

Clinical evaluation of vision therapy system 4 combined with traditional comprehensive training for ametropic amblyopia / 中华实验眼科杂志

Objective:To assess the effectiveness of Vision Therapy System 4 (VTS4) combined with traditional comprehensive training for ametropic amblyopia.Methods:A non-randomized controlled clinical study was performed.A total of 168 children aged 4-10 years with ametropic amblyopia were enrolled in The First Affiliated Hospital of Zhengzhou University from January 2018 to March 2021.The children were assigned to conventional comprehensive training combined with Vision Therapy System 4 group (conventional+ VTS4 group) and conventional group according to the preference of their guardian.Patients in conventional+ VTS4 group (84 children) received conventional comprehensive training combined VTS4 and patients in conventional group (84 children) were treated with conventional comprehensive training only, and the intervention was continuously used for over a year.Best corrected visual acuity (BCVA) of the patients converted to the logarithm of the minimum angle of resolution (LogMAR) units was examined by international standard visual acuity chart before and after therapy.Spherical equivalent of the patients was detected by optometry under cycloplegic conditions and skiascopy.Binocular and fusion vision was examined with a synoptiscope.The stereopsis was evaluated using Titmus Stereogram.The ocular axial length (AL) and mean keratometry (Km) were measured with the IOLMaster 500.The basic cure rate, BCVA, reconstruction rate of stereopsis, △SE, △AL and △Km following training were compared to evaluate the effectiveness and myopic shift between two groups.The patients in conventional+ VTS4 group were divided into 4-5 years old group and 6-10 years old group, with 42 cases in each group, and the basic cure rate, BCVA, reconstruction rate of stereopsis were compared to evaluate the therapeutic effect between the two groups.The basic cure was defined as acuity improved to ≥0.9, with reduced myopic diopter and stable therapy outcome over 6 months.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2021-KY-0891-002). Written informed consent was obtained from guardians prior to any medical examination.Results:The basic cure rate of conventional+ VTS4 group was 58.33%(49/84), which was significantly higher than 40.48%(34/84) of conventional group ( χ2=5.358, P=0.021). The BCVA in the conventional+ VTS4 group was better than that in conventional group, showing a statistically significant difference ( Z=-2.537, P=0.011). The recovery rates of binocular vision, fusion vision and stereo vision were 87.93%(51/58), 78.33%(47/60) and 70.77%(46/65) in conventional+ VTS4 group, which were higher than 65.57%(40/61), 57.81%(37/64) and 52.86%(37/70) in conventional group, respectively, with significant differences between them ( χ2=8.259, 5.968, 4.566; all at P<0.05). No significant difference was found in △SE, △AL, and △Km between conventional group and conventional+ VTS4 group (all at P>0.05). The basic cure rate was 69.05%(29/42) in the children aged 4-5 years group, which was higher than 47.62%(20/42) in 6-10 years group, respectively, showing a significant difference ( χ2=3.967, P=0.046). Both BCVA and the stereo vision recovery rate in the 4-5 years old group were better than those in the 6-10 years old group ( Z=-2.046, P=0.041; χ2=4.624, P=0.032). Conclusions:A combination therapy of VTS4 and conventional comprehensive training can improve the visual acuity and reconstruct the fusion and stereopsis of children with ametropic amblyopia, without causing additional myopic drift.

Clinical study on the application of digital and visual retinoscope in the detection of ametropia in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the application value of digital and visual retinoscope in the detection of ametropia in adolescents.<p>METHODS:A retrospective analysis of digital visual inspection and traditional retinography test results of 69 adolescents in the ophthalmology department of our hospital from January 2019 to October 2019. SPSS 20.0 software analyzed the correlation of spherical equivalent, diopter of cylindrical power and axial direction measured by two detection methods. Taking the clinical examination results as the control, the diagnostic value was compared. <p>RESULTS: There was no statistically significant difference in the measuring of spherical equivalent, diopter of cylindrical power and axial direction between digital and visual retinoscope and traditional retinography(<i>t</i>=0.081, 1.778, 0.983, <i>P</i>=0.935, 0.077, 0.327). And there was a significant positive correlation(<i>r</i>=0.745, 0.572, 0.941,<i> P</i><0.01). At the same time, two detection methods have the same sensitivity. Digital and visual retinoscope higher than traditional retinography at the specificity, accuracy, positive predictivevalue and negative predictive value.<p>CONCLUSION: The detection of ametropia in adolescents with digital and visual retinoscope has a good correlation with traditional retinography. Compared with the latter, the former has improved for the diagnosis of ametropia, which deserves clinical attention.

Cambios refractivos y de agudeza visual en pacientes pre y post quirúrgicos de Pterigión / Refractive and visual acuity changes in pre- and post-surgical patients with Pterygium / Mudanças refrativos e de acuidade visual em pacientes pré e pós cirúrgicos de Pterigión

El tratamiento quirúrgico del pterigión es uno de los procedimientos más realizados en la consulta oftalmológica, aunque con frecuencia conlleva molestias y cambios en la agudeza visual. OBJETIVO: evidenciar si existen cambios en cuanto a agudeza visual y su ametropía, en pacientes diagnosticados con pterigión intervenidos quirúrgicamente, en la ciudad de Quito. METODO: se trata de un estudio observacional longitudinal que incluyó 161 pacientes. Se comparó agudeza visual y ametropía antes y 15 días después de la intervención quirúrgica. RESULTADOS: la mayor parte de los pacientes fue de género femenino (n = 118, 73%) tuvo entre 30 y 59 años (n = 127, 79%), presentó pterigión grado III (n = 113, 70%) y fue intervenido del ojo derecho (n = 89, 55%). La agudeza visual de los pacientes mejoró ligeramente. El número de pacientes con agudeza visual 20/20 aumentó de 68 (42%) a 72 (45%). Se observó además una disminución en el número de pacientes con agudeza visual 20/350, 20/200, 20/100, 20/80, 20/60 y 20/50. No hubo cambios en el número de pacientes amétropes que se mantuvo en 69 (43%). Tanto el número de personas con astigmatismo miópico compuesto, como con astigmatismo mixto eje contra la regla disminuyeron de 11 (7%) a 8 (5%) y de 24 (15%) a 16 (10%), respectivamente. CONCLUSIÓN: tanto la agudeza visual como la ametropía de pacientes con pterigión mejoran ligeramente después de recibir tratamiento quirúrgico.

The surgical treatment of the pterygium is one of the most performed procedures in the ophthalmologic consultation, although it often involves discomfort and changes in visual acuity. OBJECTIVE: to show if there are changes in visual acuity and its ametropia, in patients diagnosed with surgically intervened pterygium, in the city of Quito. METHOD: This is a longitudinal observational study that included 161 patients. Visual acuity and ametropia were compared before and 15 days after surgery. RESULTS: most of the patients were female (n = 118, 73%), were between 30 and 59 years old (n = 127, 79%), presented grade III pterygium (n = 113, 70%) and was operated on the right eye (n = 89, 55%). The visual acuity of the patients improved slightly. The number of patients with visual acuity 20/20 increased from 68 (42%) to 72 (45%). There was also a decrease in the number of patients with visual acuity 20/350, 20/200, 20/100, 20/80, 20/60 and 20/50. There were no changes in the number of ametropic patients that remained in 69 (43%). Both the number of people with compound myopic astigmatism, and with mixed astigmatism axis against the rule decreased from 11 (7%) to 8 (5%) and from 24 (15%) to 16 (10%), respectively. CONCLUSION: both visual acuity and ametropia of patients with pterygium improve slightly after receiving surgical treatment.

O tratamento cirúrgico do pterigion é um dos procedimentos mais realizados na consulta oftalmológica, embora frequentemente implique transtornos e mudanças na acuidade visual. OBJETIVO: evidenciar se existem mudanças quanto à acuidade visual e sua ametropia, em pacientes diagnosticados com pterigion, operados cirurgicamente, na cidade de Quito. MÉTODO: é um estudo longitudinal observacional que incluiu 161 pacientes. Foi comparada acuidade visual e ametropia antes e 15 dias depois da intervenção cirúrgica. RESULTADOS: a maior parte dos pacientes foi de gênero feminino (n = 118, 73%) teve entre 30 e 59 anos (n = 127, 79%), apresentou pterigião grau III (n = 113, 70%) e foi operado do olho direito (n = 89, 55%). A acuidade visual dos pacientes melhorou ligeiramente. O número de pacientes com acuidade visual 20/20 aumentou de 68 (42%) para 72 (45%). Observou-se também uma diminuição no número de pacientes com acuidade visual 20/350, 20/200, 20/100, 20/80, 20/60 e 20/50. Não houve mudanças no número de pacientes amétropes que se manteve em 69 (43%). Tanto o número de pessoas com astigmatismo miópico composto, como com astigmatismo misto eixo contra a regra diminuíram de 11 (7%) para 8 (5%) e de 24 (15%) para 16 (10%), respectivamente. CONCLUSÃO: tanto a acuidade visual quanto a ametropia de pacientes com pterigião melhoram ligeiramente depois de receber tratamento cirúrgico.

Satisfação de pacientes submetidos à cirurgia refrativa de PresbiLASIK / Satisfaction of patients submitted to PresbyLASIK refractive surgery

Resumo Objetivos: Avaliar a satisfação dos pacientes submetidos à cirurgia de Presbilasik central e determinar a prevalência de sintomas relatados após a cirurgia. Métodos: Este é um estudo descritivo, observacional, transversal, com dados obtidos de pacientes submetidos previamente ao PresbiLASIK. Resultados: A amostra consistiu de 45 pacientes, com média de idade de 57,7 (±7,19) anos. A nota média atribuída para a satisfação visual com o procedimento foi 8.9 (±1.0). A qualidade visual após a cirurgia foi classificada como igual ou melhor que a esperada por 84,5% dos pacientes e 31% apresentaram sintomas noturnos, como halos e raios de cometa. Conclusão: A qualidade de visão após o procedimento de PresbiLASIK foi altamente satisfatória para os pacientes. Fator determinante dessa satisfação é o processo de manejo das expectativas pré-operatórias dos pacientes, informando das possibilidades terapêuticas disponíveis, e, no caso da escolha cirúrgica, acerca das vantagens e limitações.

Abstract Objectives: Toassess the satisfaction of patients undergoing central Presbilasik surgery and to determine the age of patients who undergo PresbiLASIK and the prevalence of symptoms reported after surgery. Methods: This is a descriptive, observational, cross-sectional study with data collected from patients previously submitted to PresbiLASIK. Results: The sample consisted of 45 patients, with a mean age of 57.7 (±7,19) years. The average score attributed to visual satisfaction with the procedure was 8.9 (±1.0). Visual quality after surgery was classified as equal to or better than expected by 84.5% of the patients and 31% complained of nocturnal symptoms such as halos and comet rays. Conclusion: The quality of vision after the PresbiLASIK procedure was highly satisfactory for the patients. A determining factor for this satisfaction is the process of managing patients' preoperative expectations, informing them about the therapeutic possibilities available, and, in the case of surgical choice, about its advantages and limitations.

Difference analysis of retinal structure, visual evoked potential and stereoscopic function in children with different types of amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the differences of retinal structure, visual evoked potential and visual function in different types of amblyopia children.<p>METHODS: One hundred and twenty children with 136 eyes with moderate amblyopia treated in our hospital from May 2014 to May 2018 were enrolled as the observation group(31 cases with 31 eyes of anisometropy, 35 cases with 70 eyes of refractive ametropia, and 26 cases with 35 eyes of strabismus); meanwhile, 29 children with 58 eyes with normal vision in the eye examination from our hospital were selected as the control group. Optical coherence tomography(OCT)imager was used to detect the foveal thickness of the macula, the thickness of the retinal nerve fiber layer(RNFL)around the optic disc and the quadrants, and the changes in retinal function were detected using visual electroencephalography. The P100 amplitude and latency of visual evoked potentials were observed and stereoscopic inspection being performed. <p>RESULTS: The thickness of macular fovea, the thickness of the optic disc and the RNFL in the quadrants of children with anisometropy and ametropia were significantly higher than those in the control group and children with strabismic amblyopia(<i>P</i><0.01). Compared with the control group, patients with refractive amblyopia had lower light peak potentials and longer light peak times. The dark valley potential of myopia children was higher in children with refractive amblyopia, and the Arden ratio and Gliern ratio were lower(All <i>P</i><0.01). The P100 wave amplitudes of the visual evoked potentials of the three types of amblyopia children were significantly lower than those of the control group, and the 1° and 15' spatial frequency latency periods were significantly delayed(all <i>P</i><0.01). The number of cross parallaxes, non-cross parallaxes, near-zero parallaxes, and far-sighted stereoscopic aberrations in the ametropic amblyopia group were significantly higher than those in the strabismic amblyopia group(<i>P</i><0.05), but were no different from those in the ametropic amblyopia group in terms of each indicators. <p>CONCLUSION: Retinal structure of patients with ametropic amblyopia and ametropic amblyopia has obvious abnormalities, and the P100 wave latency is delayed; strabismic amblyopia has the largest effect on stereoscopic function, while refractive amblyopia has the least effect.

Effects of refractive errors on macular blood flow and retinal thickness in school-age children assessed by OCTA / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To quantitatively analyze the macular area blood perfusion and retinal thickness of school-age children in each ametropia group by using OCT angiography technology, in order to evaluate the effect of the changes of refractive state on the macular area blood perfusion and retinal thickness during the growth and development of school-age children.<p>METHODS: In this study, 174 eyes were randomly selected from school-age children who were treated in the ophthalmic clinic from July 2018 to March 2019. The superficial retinal capillary of vessel density(SCPVD), deep retinal capillary of vessel density(DCPVD), central retinal thickness(CRT)and average retinal thickness(ART)were quantitatively analyzed using by OCT angiography technology. Additionally, the correlation between blood vessel density in macular area and retinal thickness was analyzed.<p>RESULTS: After quantitatively analysis, compared with emmetropia group, the SCPVD value of the high myopia group was decreased(<i>P</i><0.001). The DCPVD value of the hyperopia group was increased(<i>P</i>=0.004). The ART value of high myopia group was decreased(<i>P</i><0.001).There was no significant difference in CRT values between the ametropia group and the emmetropia group(<i>P</i>>0.05). SCPVD was positively correlated with ART as an independent factor(<i>r</i>=0.274, <i>P</i><0.01).<p>CONCLUSION:In the process of refractive development, SCPVD of children with high myopia decreases and ART becomes thinner. Moreover, SCPVD can be an independent factor positively correlated with ART during the whole refractive development. This suggests that the retina of school-age children with high myopia has presented pathological changes.

La hipotenusa de pitágoras como índice de ametropía

Objetivo general. Crear un índice con base en la hipotenusa de Pitágoras para representar cualquier estado refractivo y facilitar los análisis estadísticos de los pacientes amétropes. Métodos. 3964 pacientes de una base de datos de Optiláser (Centro de cirugía refractiva en Bogotá, Colombia) del año 2014 fueron seleccionados para demostrar la aplicabilidad del índice de ametropía propuesto. Los pacientes no habían sido sometidos a ningún tipo de procedimiento quirúrgico. Otro ejemplo para ilustrar la aplicabilidad del índice de ametropía viene de la investigación Madre Canguro Integral llevada a cabo entre 2013 y 2014 en el Hospital de San Ignacio, Bogotá, en la cual 311 bebés nacidos prematuramente y en buen estado de salud fueron evaluados. Los meridanos principales de las ametropías se tomaron como catetos de un triángulo rectángulo para calcular la hipotenusa que fue tomada como índice de ametropía. Seguidamente, se determinó la correlación de Spearman entre el índice de ametropía y el ángulo visual expresado con mínimo ángulo de resolución (MAR). Resultados. La correlación de Spearman entre el índice de ametropía y el mínimo ángulo de resolución es 0,834. Por tanto, es estadísticamente significativa (p:< 0,001) y suficiente para validar el índice propuesto. Conclusiones. El índice de ametropía es un instrumento válido para la evaluación, manejo y análisis estadístico de las ametropías.

Objetivo geral. Criar um índice, baseado na hipotenusa de Pitágoras, para representar qualquer estado refrativo e facilitar a análise estatística de pacientes com ametropia. Métodos. 3964 pacientes de um banco de dados do OPTILASER (Centro de Cirurgia Refrativa de Bogotá, Colômbia) em 2014, foram selecionados para demonstrar a aplicabilidade do Índice de Ametropia proposto. Os pacientes não tinham sido submetidos a nenhum tipo de procedimento cirúrgico. Outro exemplo para ilustrar a aplicabilidade do Índice de Ametropia, vem da pesquisa "Mãe Canguru Integral", realizada entre 2013 e 2014, no Hospital de San Ignacio, Bogotá, onde 311 bebês nascidos prematuramente e com boa saúde foram avaliados. Os meridianos principais da ametropia são tomados como catetos de um triângulo retângulo para calcular a hipotenusa que será tomada como o índice de ametropia. Em seguida, foi determinada a correlação de Spearman entre o Índice de Ametropia e o Ângulo Visual expresso com o Ângulo Mínimo de Resolução (Mínimo Ángulo de Resolución, MAR). Resultados. A correlação de Spearman entre o Índice de Ametropia e o Ângulo Mínimo de Resolução é de 0,834, o que é estatisticamente significativo (p <0,001) e suficiente para validar o Índice proposto. Conclusões. O índice de ametropia é um instrumento válido para a avaliação, manejo e análise estatística das ametropia.

General Objective. To create a suitable Index, based on Pythagoras' hypotenuse, to represent any refractive state and to facilitate statistical analyses of ametropic patients. Methods. 3964 patients from a database of OPTILASER (Refractive Surgery Center in Bogotá, Colombia) for the year 2014 were selected to demonstrate the applicability of the proposed Index of Ametropia. The patients had not been previously subjected to any kind of surgical procedure. Another example to illustrate the applicability of the proposed Index of Refraction comes from a database of an investigation "Madre Canguro Integral" (Integral Kangaroo Mother), carried out between 2013 and 2014 at Hospital San Ignacio, Bogotá in which 311 healthy prematurely-born babies were evaluated Principal meridians of ametropias are taken as catheti of a right triangle in order to calculate the Hypotenuse which will be taken as the Index of Ametropia. Spearman Correlation, between the Index of Ametropia and the Visual Acuity expressed as the Minimum Angle of Resolution (MAR), are determined. Results. Spearman Correlation between the Index of Ametropia and the Minimum Angle of Resolution is 0,834 statistically significant (p: < 0,001) ample enough to validate the proposed Index of Ametropia. Conclusions. The Index of Ametropia is a valid instrument for the assessment, management and statistical analysis of ametropias.

Effect of axial length and corneal curvature radius and their ratio on refractive errors in children and adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the association between refractive status and refractive factors, and to explore the effectiveness of mean ocular axial length(AL), mean corneal radius of curvature(CR)and their ratio in the assessment of amitropia in children and adolescents.<p>METHODS: Cross sectional study, 816 cases(1632 eyes)aged 3-16 years old suspected ametropia were selected in the Affiliated Eye Hospital of Nanjing Medical University from December 2017 to December 2018. Uncorrected visual acuity(UCVA), mean AL and mean CR were tested. Autorefraction was performed after cycloplegia, which was measured as the spherical equivalent(SE).<p>RESULTS: Among 816 cases of children and adolescents aged 3-16, 773 were ametropia, accounting for 94.7%, with the highest proportion aged 7-14. The difference(one eye)in the mean AL, and AL/CR ratio of different refractive groups were statistically significant(<i>P</i><0.05). In different refractive states, the mean AL and AL/CR ratio showed a low correlation with SE in emmetropes and low hyperopes but higher correlation in moderately hyperopic and myopic children. The mean AL, AL/CR ratio were higher correlation with SE increased with age. Sensitivity was 0.880, specificity was 0.916, and accuracy was 89.2%. The area under ROC curve was 0.954.<p>CONCLUSION: The proportion of myopia among children and adolescents gradually increases and shows a large increase after 7 years old. The AL and AL/CR ratio showed higher correlation in moderate hyperopes, myopes and older ages. The AL/CR ratio is highly accurate in the diagnosis of myopia in adolescents and children.

Analysis on poor eyesight and ametropia in students of different learning stages in Baoshan District in 2017 / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze the visual acuity and diopter of students at different learning stages in Baoshan District, Shanghai. <p>METHODS: By stratified random sampling, 3002 students were randomly selected from 14 grades of Baoshan from middle class in kindergarten to senior three in middle school. Chi-square analysis and Kruskal-Wallis <i>H</i> test were used to compare the difference of myopia rate, refractive error rate and visual impairment among students at different learning stages and gender. <p>RESULTS: With the increase of learning stage, the rate of poor eyesight increased from 18.52% to 87.12%. There were differences in the rate of poor eyesight among different learning stages(<i>P</i><0.05). There were differences in the proportion of poor eyesight between boys and girls in junior and senior middle schools(<i>P</i><0.05). There were differences in the rate of poor eyesight with different degrees(<i>P</i><0.01). The proportion of myopia in different learning stages was different(<i>P</i><0.05).<p>CONCLUSION:The rate of poor eyesight in students is high in Baoshan District. Attention should be paid to eye care of students.

Antecedentes y actualidad de las lentes fáquicas para la corrección de las ametropías / Antecedents and current status of the use of phakic lenses for ametropia correction

La cirugía refractiva es una subespecialidad que comprende todos los procedimientos quirúrgicos dirigidos a modificar la refracción ocular en sus distintas ametropías. Su finalidad es mejorar la agudeza visual no corregida y simultáneamente disminuir la dependencia de los anteojos o lentes de contacto. Existen diferentes opciones como son: los procedimientos queratorrefractivos y los implantes de lentes intraoculares, con extracción del cristalino (pseudofaquia) o en un ojo fáquico, entre la córnea y el cristalino. En ocasiones es necesaria la combinación de más de un procedimiento. Las lentes intraoculares fáquicas pueden dividirse en dos grupos: lentes de cámara anterior, que incluye las de soporte angular y las de fijación iridiana, y lentes de cámara posterior, que son las implantadas en surco. A diferencia de la cirugía láser sobre la córnea o de la cirugía del cristalino, la corrección de ametropías moderadas-severas mediante estas lentes permite mantener la acomodación, además de obtener una mejor calidad óptica, cierta reversibilidad del procedimiento y la posibilidad de mejorar defectos refractivos residuales mediante la cirugía corneal mínima. De ahí la motivación para realizar una búsqueda de diversos artículos publicados, con el objetivo de describir todos los tipos de lentes intraoculares en ojos fáquicos y sus ventajas. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)

Refractive surgery is a subspecialty comprising all the surgical procedures aimed at modifying ocular refraction in its various ametropias. Its aim is to improve uncorrected visual acuity, reducing dependence on eyeglasses or contact lenses. There are different options, such as keratorefractive procedures and intraocular lens implantation, with removal of the crystalline lens (pseudophakia) or in phakic eyes, between the cornea and the crystalline lens. A combination of more than one procedure is sometimes required. Phakic intraocular lenses are divided into two groups: anterior chamber lenses, including the angle-supported and iris fixation types, and posterior chamber lenses, performed by sulcus implantation. Unlike laser corneal or crystalline lens surgery, correction of moderate-to-severe ametropia using these lenses makes it possible to retain accommodation, and provides better optical quality, a certain reversibility of the procedure, and the possibility of correcting residual refractive defects by minimum corneal surgery. Hence the motivation to conduct an updated search in various published papers with the purpose of describing all the types of phakic intraocular lenses and their advantages. Use was made of the Infomed platform, particularly the Virtual Health Library with all its search engines(AU)

Prevalência de ametropias e anisometropias em crianças no ensino fundamental nas escolas de 14 municípios do Estado de Alagoas / Prevalence of ametropias and anisometropias in elementary school children in schools from 14 cities in the State of Alagoas

RESUMO Objetivo: Avaliar a Prevalência de ametropias e anisometropias em crianças no ensino fundamental nas escolas de 14 municípios do estado de Alagoas. Métodos: Realizado um Estudo retrospectivo com dados de 40.873 alunos na faixa etária de 7 a 15 anos. Os pacientes com qualquer erro refrativo foram considerados ametropes e erros maiores que - 0,75D ou + 2,00D esféricos ou maiores que -0,75D cilíndricos com queixas visuais significativas tiveram óculos prescritos e anisometropia considerada com a diferença maior de duas dioptrias. Resultados: Encontrado prevalência, 5,2% de ametropias. Astigmatismo miópico composto (28,99%), seguido de astigmatismo hipermetrópico composto (20,39%). E anisometropia, de 10.38%. Conclusão: Conhecer a prevalência infanto-juvenil de ametropias e anisometropia na população é fundamental para a adoção de estratégias para diagnóstico e tratamento correto de causas evitáveis de baixa visão.

ABSTRACT Objective: Evaluate a prevalence of ametropias and anisometropias in elementar school children from 14 cities in the state of Alagoas. Methods: A retrospective study, total of 40.873 students, between 7 and 15 years of age, were examined. Patients presenting any refractive error were considered ametropic. Only patients claiming eye complaints with spherical errors greater than -0.75D or +2.00D and cylinder error greater than -0.75D were prescribed eyeglasses. Anisometropia was considered when the refractive difference between the two eyes was of 2 diopters or more. Results: 5.2% presented ametropia. Compound myopic astigmatism (28.99%) and compound hyperopic astigmatism (20.39%). And anisometropias was 10.38%. Conclusions: Understanding the prevalence of ametropias and anisometropias among children is essential to implement strategies for the correct diagnosis and treatment of avoidable visual impairment causes.

Research of near stereopsis in clinical treated amblyopes / 安徽医科大学学报

104 successful treated amblyopes were screened from the ophthalmology outpatient departmt,who had successfully amblyopia treatment,all with the corrective visual acuity around 0.8 and the visual acuity of two eyes were less than two lines.Titmus stereogram was used to test stereoacuity,the chi-square test was used to analyze the results.There was statistical significance between the three types of amblyopia(x2 =11.294,P ＜ 0.05),individuals with ametropic amblyopia have better stereoacuity than others,individuals with anisometropic amblyopia and strabismic amblyopia have worse stereoacuity than others;There was statistical significance between different degrees of amblyopia (x2 =13.455,P ＜ 0.05),individuals with mild and moderate amblyopia have better stereoacuity than others,individuals with severe amblyopia have worse stereoacuity than others;There was statistical significance between differentdiagnosed age (x2 =11.263,P ＜ 0.05),the first diagnosed age less than 7 years old was better than over 7 years old;No difference was identified between thestereoacuity of monocular and binocular amblyopia.The visual acuity of different kinds of amblyopia could recover to normal level after regular amblyopia treatment,however,the stereoacuity has not recovered to normal level,it is necessary to take exercise to improve binocular function.As a result,the stereoacuity is considered to be a standard to evaluate the effect of amblyopia treatment.

DTI analysis on white matter changes in children with ametropic amblyopia / 眼科新进展

Objective To evaluate white matter nerve fiber changes of children with binocular ametropic amblyopia by applying the technology of diffusion tensor imaging and the whole brain analysis method of deterministic tractography,and analyze its correlation with visual acuity.Methods Fourteen binocular ametropic amblyopia children was collected from the Second Xiangya Hospital of Central South University as study subject of experimental group,14 cases of normal sight children as the control group.All children were scanned by MRI system,conventional MRI examination,3DTlWI scan were made,then echo-planar sequence scanning was used to obtain diffusion tensor imaging.Quantitative analysis was made to all diffusion tensor imaging using deterministic tractography.Using the experimental group tracts with statistic changes of FA value,volume and tract count as the region of interest(ROI),the correlation analysis with vision for each ROI was performed.Results Isoametropic amblyopia children demonstrated low FA values in the right ventral and dorsal pathway,right optic radiation and corpus callosum compared to control group.There was low volume of fibers in the bilateral ventral and dorsal pathway,the left optic radiation and body of corpus callosum compared to control group.The tract count of right dorsal pathway had reduced compared to control group.Among FA value,tract count and volume,FA value had the maximum regression coefficient with visual acuity,the regression coefficient of tract count and volume was small.The relative correlation coefficient of FA value at right optic radiation,right ventral pathway and body of corpus callosum with vision acuity were 0.486,0.534 and 0.456,respectively,the right ventral pathway had the maximum correlation with visual acuity.Conclusion Isoametropic amblyopia patients shows abnormal structure on bilateral optic radiation,bilateral ventral and dorsal pathway and body of corpus cailosum,these may cause the capability loss of object recognition and spatial position recognition.The FA value of right ventral pathway has the maximum influence on visual acuity.

Clinical analysis of outpatients with ametropia in Hebeisheng Eye Hospital / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To perform a clinical analysis of 1 500 cases of outpatients with ametropia in Hebeisheng Eye Hospital,to provide a theoretical basis for diagnosis,treatment,and prevention of patients with ametropia.METHODS:Totally 1500 cases (2840 eyes) of outpatient with ametropia were chosen as the research objects in Hebeisheng Eye Hospital from June 2013 to July 2014.All cases were treated with TOPCON RM-8800 computer optometry instrument for objective optometry,and used TOPCON phoropter for subjective optometry.The combination of the two instruments was taken to determine the diopter later.Diopter and axial distribution of the myopic astigmatism and hyperopic astigmatism were observed,age of astigmatic patient,distribution of astigmatism axis were observed as well.Meanwhile,a total of 150 cases were chosen randomly to measure their corneal curvature,anterior chamber depth,axial length and other static refractive index.All indexes were compared with those of the normal people subsequently,such as amplitude of accommodation,negative relative accommodation,positive relative accommodation,sensitivity of accommodation and other dynamic refractive index.RESULTS:Ametropia types of all patients were mainly simple myopia,simple myopia astigmatism,compound myopic astigmatism,simple hypermetropia,simple hyperopia astigmatism,compound hyperopic astigmatism and mixed astigmatism,the proportion were 38.99％,3.27％,23.94％,4.68％,1.34％,13.52％,15.25％ respectively.There were 773 eyes with myopia astigmatism.The proportion of people with a myopia astigmatism diopter of above-0.25 to-0.50,-0.75 to -1.00,-1.25 to-1.50,above-1.75 were 31.05％,38.55％,16.56％,13.84％.There were 421 eyes with hyperopia astigmatism,the proportion of people with hyperopia astigmatism diopter of 0.25-0.50,0.75-1.00,1.25-1.50,＞1.75 were 26.60％,24.94％,16.63％,31.83％.Static refractive index of 150 patients (300 eyes) showed that corneal curvature was (41.23 ± 2.43) φ/D,anterior chamber depth was 3.71 ± 0.43mm,axial length 23.45 ± 1.43mm.Dynamic refractive index showed that the amplitude of accommodation 10.56±2.32D,negative relative accommodation 2.31 ±0.47D,positive relative accommodation-1.82-± 0.67D,sensitivity of accommodation 11.34±2.21D.All kinds of static and dynamic refractive indexes,the length of ocular axis were statistically different from those of the normal population (P ＜ 0.05).Regular astigmatism number rate in 1 194 cases of astigmatism eyes of 3-7 years old,8-18 years old,19-45 years old,46-60 years old were 35.85％,11.98％,45.64％,6.53％.Among 150 cases of patients (300 eyes),there were 152 eyes of equivalent sphere mirror ＜-0.5D,48 eyes of equivalent sphere mirror ≥ 0.5D,100 eyes of equivalent sphere mirror between-0.5D to 0.5D.And there were 150 eyes of equivalent sphere mirror ＜-0.5D,50 eyes of equivalent sphere mirror ≥0.5D,100 eyes of equivalent sphere mirror between-0.5D to 0.5D in a total of 300 eyes of 150 normal people.CONCLUSION:The 1500 cases of patients with ametropia (2 840 eyes) contains mainly simple myopia and compound myopic astigmatism,diopter range in myopia astigmatism were chiefly-0.25 to-0.50,-0.75 to-1.00,hyperopia diopter range consists of ＞ 1.75 mostly,among the patients with astigmatism,the older the age,the bigger the number of people with irregular astigmatism,static and dynamic refractive index of patients with ametropic eye shows apparent difference with that of the normal population.